                                 CODE OF VIRGINIA

CLAIMS PAID TO INSUREDS FOR SERVICES FROM NONPARTICIPATING PHYSICIANS (§
38.2-3407.13:2)

When an insurer, health services plan or health maintenance organization follows
a policy of sending its payment to the insured, subscriber or enrollee for a
claim for services received from a nonparticipating physician or osteopath, the
insurer, health services plan or health maintenance organization shall: (i)
include language in the certificate or evidence of coverage of the insured,
subscriber or enrollee that notifies the insured, subscriber or enrollee of the
responsibility to apply the plan payment to the claim from such nonparticipating
provider, (ii) include this language with any such payment sent to the insured,
subscriber or enrollee, and (iii) include the name and any last known address of
the nonparticipating provider on the explanation of benefits statement.

HISTORY: 2005, c. 739.